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单早期姑息治疗干预联合常规肿瘤学治疗晚期癌症患者:一项随机对照试验(SENS 试验)。

Single early palliative care intervention added to usual oncology care for patients with advanced cancer: A randomized controlled trial (SENS Trial).

机构信息

University Center for Palliative Care, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Unit for Specialized Palliative Care, Lindenhof Hospital, Bern, Switzerland.

出版信息

Palliat Med. 2021 Jun;35(6):1108-1117. doi: 10.1177/02692163211005340. Epub 2021 Apr 28.

Abstract

BACKGROUND

International oncology societies recommend early palliative care. Specific models to integrate early palliative care efficiently into clinical practice are debated. The authors designed a study to look at the quantitative and qualitative outcomes of an early palliative care intervention in oncological care to decrease stress and improve quality of life.

AIMS

To compare a single structured early palliative care intervention added to a usual oncology care in terms of distress and health-related quality of life at baseline compared to 6 months after enrollment.

DESIGN

This multicenter randomized controlled trial (NCT01983956) enrolled adult patients with advanced cancer. Participants were either randomly assigned to usual oncology care alone or usual care plus a structured early palliative care intervention.

SETTING/PARTICIPANTS: One hundred fifty adult patients with a variety of advanced cancer diagnoses were randomized. Seventy-four participants were in the intervention and 76 participants in the control group. The primary outcome was the change in patient distress assessed by the National Comprehensive Cancer Network distress thermometer at 6 months. Health-related quality of life, the secondary outcome, was assessed by the Functional Assessment of Cancer Therapy-General Questionnaire.

RESULTS

The results showed no significant effect of the early palliative care intervention neither on patient distress nor on health-related quality of life.

CONCLUSION

The addition of an early intervention to usual care for patients with advanced cancer did not improve distress or quality of life. Thus, patients may need more intensive early palliative care with continuous professional support to identify and address their palliative needs early.

摘要

背景

国际肿瘤学会建议早期姑息治疗。目前正在讨论如何将早期姑息治疗有效地纳入临床实践的具体模式。作者设计了一项研究,旨在观察在肿瘤学护理中进行早期姑息治疗干预的定量和定性结果,以减轻压力并提高生活质量。

目的

与基线相比,比较在常规肿瘤学护理中加入单一结构化早期姑息治疗干预在减轻痛苦和改善健康相关生活质量方面的效果。

设计

这是一项多中心随机对照试验(NCT01983956),纳入了患有晚期癌症的成年患者。参与者随机分配接受常规肿瘤学护理或常规护理加结构化早期姑息治疗干预。

地点/参与者:共纳入 150 名患有各种晚期癌症诊断的成年患者。74 名参与者接受干预,76 名参与者接受对照。主要结局是通过国家综合癌症网络痛苦温度计在 6 个月时评估的患者痛苦变化。次要结局是健康相关生活质量,通过癌症治疗功能评估-一般问卷评估。

结果

结果显示早期姑息治疗干预对患者的痛苦或健康相关生活质量没有显著影响。

结论

在常规护理中加入早期干预措施并不能改善晚期癌症患者的痛苦或生活质量。因此,患者可能需要更密集的早期姑息治疗,需要持续的专业支持,以便及早识别和解决他们的姑息治疗需求。

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